Glucose

INSTRUCTIONS FOR MEDICAL USE OF THE MEDICINAL PRODUCT GLUCOSE (GLUCOSE)

Composition:

active substance: glucose;

1 ml of solution contains glucose monohydrate 100 mg (calculated as 100 % substance);
excipient: water for injections.

Medicinal form. Infusion solution.

Main physicochemical properties: colorless or slightly yellowish clear liquid.

Pharmacotherapeutic group. Solutions for parenteral nutrition.

ATC code V06D C01.

Pharmacological properties.

Pharmacodynamics.

Glucose solution exerts plasma-expanding, hydrating, metabolic, and detoxifying effects. It maintains circulating blood volume and replenishes lost fluid volume. It may induce diuresis depending on the patient's clinical condition. Glucose undergoes complete metabolism, may reduce protein and nitrogen loss, promotes glycogen deposition, and reduces or prevents ketosis (excessive formation of ketone bodies) when administered in sufficient doses. During tissue metabolism of glucose, a significant amount of energy is released, which is essential for vital functions of the organism.

Pharmacokinetics.

Normal blood glucose levels range between 45–85 mg/100 mL, corresponding to a molar concentration of 3.0–5.6 mmol/L. To maintain these levels, daily intake in an adult weighing 60–100 kg should amount to 100–200 g. The contribution of blood glucose to total plasma osmolarity – 290 mOsm/L – is insignificant, only 5.6 mOsm/L. Thus, administration of glucose solutions does not noticeably affect plasma osmolarity due to rapid glucose utilization. In patients receiving glucose solely via intravenous infusion, the minimum daily requirement to prevent acidosis is 100 g of glucose (2000 mL of 5% glucose solution).

Glucose metabolism in the body ends with the formation of carbon dioxide (CO₂) and water; during aerobic glycolysis, one mole of glucose releases 686 kcal, or 4.1 kcal per 1 g.

Glucose elimination is practically achieved entirely through metabolism. Under normal conditions, glucose can be detected in urine only in trace amounts, as it is completely reabsorbed in the proximal tubules following glomerular filtration; this process continues until blood glucose levels rise to values below 200–240 mg/100 mL.

Clinical characteristics.

Indications.

• Hypoglycemia;
• parenteral nutrition;
• conditions associated with increased protein breakdown due to hyperglycemia.

Contraindications.

Glucose 10% solution for infusion is contraindicated in patients with:

• intracranial and intraspinal hemorrhages, except in conditions associated with hypoglycemia and requiring parenteral nutrition;
• severe hyperosmolar dehydration;
• hypersensitivity to glucose;
• diabetic coma with hyperglycemia;
• hyperosmolar coma;
• glucose-galactose malabsorption syndrome.

The preparation must not be administered simultaneously with blood products.

Interaction with other medicinal products and other forms of interactions.

When used concomitantly with thiazide diuretics and furosemide, their potential to affect serum glucose levels should be taken into account.

Insulin promotes glucose uptake into peripheral tissues, stimulates glycogen formation, protein and fatty acid synthesis. Glucose solution reduces the hepatotoxic effect of pyrazinamide. Administration of a large volume of glucose solution may lead to hypokalemia, thereby increasing the toxicity of concurrently administered cardiac glycosides. Glucose solution is incompatible with aminophylline, barbiturates, erythromycin, hydrocortisone, kanamycin, soluble sulfonamides, and cyanocobalamin.

Special precautions for use.

During prolonged intravenous administration of the drug, monitoring of blood glucose levels is required.

When administering the drug, subcutaneous insulin should be prescribed at a dose of 1 IU per 4–5 g of glucose.

Use during pregnancy or breastfeeding.

The drug may be used only when the expected benefit to the woman outweighs the potential risk to the fetus or infant.

Ability to affect reaction speed when driving or operating machinery.

Data are lacking due to the drug being used exclusively under hospital conditions.

Method of administration and dosage.

The drug is administered intravenously by drip infusion. The dose for adults is up to 1500 mL per day. The maximum daily dose for adults is 2000 mL. If necessary, the maximum infusion rate for adults is 150 drops per minute (500 mL/h).

Children.

The dose for children depends on age, body weight, patient's condition, and laboratory parameters.

Overdose.

Exaggeration of adverse reactions. Tachypnea, pulmonary edema.

Hyperglycemia and fluid overload may develop. In case of overdose, symptomatic treatment should be administered and, if necessary, regular insulin preparations should be given.

Side effects.

Central nervous system:

• Very rare – confusion or loss of consciousness.

Endocrine system and metabolism:

• Hyperglycemia;
• Hypokalemia;
• Hypophosphatemia;
• Hypomagnesemia.

Urinary system:

• Polyuria;
• Glucosuria.

Gastrointestinal tract disorders:

• Polydipsia;
• Nausea.

General reactions:

• Hypervolemia;
• Feeling of warmth and skin flushing;
• Allergic reactions (hyperthermia, skin rashes, angioneurotic edema, shock).

Local reactions at the injection site:

• Pain at the injection site;
• Venous irritation, phlebitis, venous thrombosis.

If adverse reactions occur, administration of the solution should be discontinued, the patient's condition should be assessed, and appropriate supportive measures should be provided.

Shelf life. 3 years.

Storage conditions. Store out of reach of children. Store in a dry, light-protected place at a temperature not exceeding 25 °C. Do not freeze.

Incompatibility. Glucose solution is incompatible with aminophylline, soluble barbiturates, erythromycin, hydrocortisone, warfarin, kanamycin, soluble sulfonamides, and cyanocobalamin.

Do not use in the same infusion system simultaneously with, or before, or after blood transfusion due to the risk of pseudoagglutination.

Packaging. 200 ml in glass bottles.

Prescription category. Prescription only.

Manufacturer: TOB "Yuria-Pharm".

Manufacturer's address and location of business activities:
108, Kobzarska St., Cherkasy, Cherkasy region, 18030, Ukraine. Tel.: (044) 281-01-01.